Textbook of Plastic and Reconstructive Surgery

Edited by Deepak M. Kalaskar, Peter E. Butler & Shadi Ghali

Aesthetic Surgery - Aesthetic Breast Surgery

1. Basics

1.1. Breast embryology, development and anatomy

An understanding of the basic embryological, development and anatomical concepts will give the reader a better understanding of the key surgical concepts in aesthetic breast surgery.

1.1.1. Embryology and development

Table 18.1 summarises the timeline of the embryonic developmental of the breast (Crosby, 2007; Schoenwolf et al., 2008).

Table 18.1. Embryological development of the breast.

WeekEmbryonic development
4Mammary ridges develop from areas of future axillae and groins (Figure 18.1)
5Primary bud formation; mammary ridges disappear except at breast sites
10Branching of primary bud
12Formation of several secondary buds which lengthen and branch
BirthOpening of lactiferous ducts (15–20) into mammary pit (small superficial depression)

Figure 18.1.
Mammary ridge (milk line) running from the anterior axillary line through the nipple to the pubic tubercle. (© J. Ruston.)

From birth to adolescence, development of the breast is quiescent. At puberty, multiple hormonal influences initiate breast development and maturation continues until maximal height is achieved (Azurin et al., 2010). Figure 18.2 shows the Tanner stages of breast development, which illustrate thisprocess (Herman-Giddens and Bourdony, 1995). Involution of the breast starts at menopause (Azurin et al., 2010).

Figure 18.2.
Tanner stages of breast development. (© J. Ruston.)